DIT – Tumor Markers ACM – Flashcards
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Oncogene
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Gain of function --> increased cancer risk, need damage to only one allele
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abl
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oncogene associated with CML, product is tyrosine kinase
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c-myc
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oncogene associated with burkitt's lymphoma, product is transcription factor
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bcl-2
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oncogene associated with follicular and undifferentiated lymphomas (inhibits apoptosis), product is anti-apoptotic molecule
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HER2/neu (c-erbB2)
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oncogene associated with breast, ovarian, and gastric carcinomas, product is tyrosine kinase
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ras
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oncogene associated with colon carcinoma, gene product is GTPase
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L-myc
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oncogene associated with Lung tumor, gene product is transcription factor
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N-myc
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oncogene associated with Neuroblastoma, gene product is transcription factor
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ret
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oncogene associated with MEN 2A and MEN2B, gene product is tyrosine kinase
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c-kit
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oncogene associated with GIST (gastrointestinal stromal tumor), gene product is cytokine receptor
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Tumor suppressor genes (tsg)
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Loss of function leads to increased cancer risk; both alleles must be lost for expression of disease
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Rb associated with
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tsg associated with retinoblastoma, osteosarcoma
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Rb gene product
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inhibits E2F; blocks G1--> S phase
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p53 associated with
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tsg associated with most human cancers, Li-Fraumeni syndrome
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p53 gene product
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transcription factor for p21, blocks G1--> S phase
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BRCA1 associated with
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tsg associated with breast and ovarian cancer
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BRCA1 gene product
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DNA repair protein
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BRCA2 associated with
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tsg associated with breast and ovarian cancer
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BRCA2 gene product
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DNA repair protein
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p16 associated with
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tsg associated with melanoma
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BRAF associated with
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tsg associated with melanoma
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BRAF gene product
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B-raf
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APC associated with
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tsg associated with colorectal cancer (associated with FAP)
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WT1 associated with
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tsg associated with Wilm's tumor (nephroblastoma)
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NF1 associated with
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tsg associated with NeuroFibromatosis type 1
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NF1 gene product
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RAS GTPase activating protein (RAS-GAP)
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NF2 associated with
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tsg associated with NeuroFibromatosis type 2
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NF2 gene product
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Merlin (schwannomin) protein
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DPC4 associated with
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tsg associated with pancreatic cancer
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DPC4 gene product
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DPC - Deleted in Pancreatic Cancer
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DCC associated with
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tsg associated with colon cancer
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DCC gene product
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DCC - Deleted in Colon Cancer
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Tumor markers
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...
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PSA
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prostate specific antigen, used to follow prostate cancer, may also be elevated in BPH and prostatitis.
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Prostatic acid phosphatase
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Prostate carcinoma
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CEA
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CarcinoEmbryonic Antigen - nonspecific but produced by colorectal and pancreatic cancers. Also gastric, breast, and medullary thyroid cancers.
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alpha fetoprotein
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Normally made by fetus. Hepatocellular carcinomas, nonseminomatous germ cell tumors (testis, ovary)
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B-hCG
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Hydatidiform moles and Chorioarcinomas (Gestational trophoblastic disease)
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CA-125
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Ovarian cancer
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S-100
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melanoma, neural tumors, schwannomas
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alkaline phosphatase
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metastases to bone, liver pager's disease of bone
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bombesin
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neuroblastoma, lung and gastric cancer...lol this makes me think of the song "mr. bombastic"
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TRAP
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Tartrate-Resistant Acid Phosphatase (TRAP), hair cell leukemia - a B-cell neoplasm "TRAP the hairy animal"
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CA-19-9
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specific for pancreatic cancer! (pancreatic adenocarcinoma)
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calcitonin
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medullary thyroid carcinoma
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Oncogenic microbes
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HTLV-1
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microbe associated with adult T-cell leukemia/lymphoma
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HBV, HCV
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microbe associated with hepatocellular carcinoma
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EBV
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microbe associated with Burkitt's lymphoma, hodgkin's lymphoma, nasopharyngeal carcinoma, CNS lymphoma (in immunocompromised patients)
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HPV
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microbe associated with cervical carcinoma (16, 18), penile/anal carcinoma, upper respiratory SCC
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HHV-8
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microbe associated with Kaposi's sarcoma, body cavity fluid B-cell lymphoma
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H pylori
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microbe associated with gastric adenocarcinoma and lymphoma
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Schistosoma haematobium
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microbe associated with bladder cancer (squamous cell)
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Liver fluke (Clonorchis sinensis)
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microbe associated with cholangiocarcinoma
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Disease conditions associated with neoplasms
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...
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Down syndrome
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ALL (we ALL fall DOWN), AML
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xeroderma pigmentosum, albinism
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melanoma, basal cell carcinoma and especially squamous cell carcinoma of skin
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chronic atrophic gastritis, pernicious anemia, post surgical gastric remnants
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Gastric adenocarcinoma
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Tuberous sclerosis (facial angiofibroma, seizures, mental retardation, ash leaf spots)
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Giant cell astrocytoma, renal angiomyolipoma, cardiac rhabdomyoma
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Actinic keratosis
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squamous cell carcinoma of skin
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Barrett's esophagus (chronic Gi reflux)
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esophageal adenocarcinoma
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Plummer-Vinson syndrome (decreased iron)
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squamous cell carcinoma of esophagus
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cirrhosis (alcoholic, hep B or C)
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hepatocellular carcinoma
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ulcerative colitis
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colonic adenocarcinoma
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paget's disease of bone
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2ndary osteosarcoma and fibrosarcoma
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immunodeficiency states
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malignant lymphomas
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AIDS
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aggressive malignant lymphomas (non-hodgkin's) and kaposi's sarcoma
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autoimmune disease (Hashimoto's thyroiditis, myasthenia gravis, etc)
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lymphoma
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acanthosis nigricans (hyperpigmentation and epidermal thickening)
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visceral malignancy (stomach, lung, uterus)
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dysplastic nevus
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malignant melanoma
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radiation exposure
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leukemia, sarcoma, papillary thyroid cancer, and breast cancer
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chemical carcinogens
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name organ and impact
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aflatoxins (aspergillus)
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liver, hepatocellular carcinoma
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vinyl chloride
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liver, angiosarcoma
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carbon tetrachloride
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liver, centrilobular necrosis, fatty change
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nitrosamines (smoked foods)
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stomach, gastric cancer
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cigarette smoke
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larynx, squamous cell carcinoma lung, squamous and small cell carcinoma kidney, renal cell carcinoma bladder, transitional cell carcinoma pancreas, pancreatic adenocarcinoma
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asbestos
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lung, bronchogenic carcinoma > mesothelioma
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arsenic
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skin, squamous cell carcinoma liver, angiosarcoma
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napthalene (aniline) dyes
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bladder, transitional cell carcinoma
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alkylating agents
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blood, leukemia
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paraneoplastic syndrome
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describe effect and neoplasms associated with them
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ACTH or ACTH-like peptide
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cushing's syndrome, small cell lung carcinoma
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ADH
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SIADH, small cell lung carcinoma and intracranial neoplasms
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PTHrP
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hypercalcemia, squamous cell lung carcinoma, renal cell carcinoma, breast cancer
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1,25-OH2D3 (calcitriol)
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hypercalcemia, hodgkin's lymphoma, some non-hodgkin's lymphomas
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erythropoietin
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polycythemia, renal cell carcinoma, hemangioblastoma, hepatocellular carcinoma, pheochromocytoma
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antibodies against presynaptic calcium channels at NMJ
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lambert-eaton syndrome (muscle weakness), small cell lung carcinoma
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define psammoma bodies
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laminated, concentric, calcific spherules
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where are psammoma bodies found?
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PSaMMoma: Papillary (thyroid) Serous (ovary) Meningioma Mesothelioma
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rate cancers based on highest to lowest incidence in males
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prostate > lung > colon/rectum
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rate cancers based on highest to lowest incidence in females
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breast>lung>colon/rectum
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rate cancers based on highest to lowest mortality in males
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lung > prostate
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rate cancers based on highest to lowest mortality in females
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lung > breast
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what is the leading cause of death in US?
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heart disease
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2nd leading cause of death in US?
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cancer
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brain metastasis most likely from...
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lung>breast>GU>osteosarcoma>melanoma>GI 50% brain tumors are from metastases. typically multiple well circumcised tumors at gray/white matter junction
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liver metastasis most likely from...
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colon>>stomach>pancreas liver and lung are most common sites of metastasis after regional lymph nodes
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bone metastasis most likely from...
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prostate, breast > lung > thyroid, testes bone metastasis >> primary bone tumors lung = lytic prostate = blastic breast = lytic and blastic from DIT: "Permanently Relocated Tumors Like Bones" = prostate, renal cell, testes/thyroid, lung, breast
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Tumor markers for pancreatic cancer
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CA 19-9 and CEA
